This proposal will test the hypotheses that exercise and daily administration of oxandrolone, propranolol, or ketoconazole will benefit severely burned children in their recovery to normal physiological function. An intervention study will be performed in which clinically relevant outcomes will be quantified at three-month intervals. Patients will be randomized into five groups to receive exercise plus oxandrolone, propranolol, ketoconazole, or placebo given by pill. The fifth group will receive home care. Primary endpoints during the first year after burn are: resting energy expenditure, linear growth, body composition, muscle strength, and hemodynamic function. Other measures to support the hypotheses include weight, liver size, total energy expenditure, bone mineral content and density, and hormone and drug blood and urine levels. Body composition, height, and weight will be followed yearly until the patient is 18 years of age. Support of this project allows a unique group of clinicians and basic scientists the rare opportunity of examining the mechanisms in which exercise and anabolic and anti-catabolic agents effect protein synthesis, degradation in muscle, fat synthesis and oxidation, and how these mechanisms translate into clinical outcomes and eady rehabilitation in severely burned children.